The Value Of Narrow Band Imaging Laryngoscope In Diagnosis Of Laryngeal Cancer

Objective:To investigate the clinical value of narrow band imaging (NBI) in thediagnosis of laryngeal cancer.Method:We chose104qualified patients based on the fact that they all had a longhistory of smoking cigarettes with uncomfortable feelings related to throat likeforeign body sensation, blood-stained sputum, accompanied by hoarseness ornot, and had the suspicion of suffering from laryngeal carcinomas by electroniclaryngoscope examination in our department from June2013to March2014. Weexamined the larynx with normal and NBI scope separately in every case, thenobserved the intraepithelial papillary capillary loop(IPCL) on the surface ofneoplasms under NBI mode as well as primarily judged the tumor’s nature. Atlast, the sensitivity, specificity, positive and negative predictive value werecompared and differentiated separately between the normal and the NBI modes.Besides, we also wanted to illustrate the relationship of IPCL and historicalclassification in this paper.Results：(1) We can clearly observe the form of capillaries on the superficialmembrane. The tumor presents dense brown spots in irregular arrangement, whose boundary could be more clearly shown, under NBI scope. The bigger andirregular these dots are, the more possible the tumor are to be malignant. As thecarcinoma proceeds, papillary could twist like trabs, with shapes of tadpole,earthworm and snake. Serious dysplasia and carcinoma in situ were similarlycharacterized by relatively big spots, which were viewed much smaller andarranged well in slight and moderate hyperplasia, while disappeared in simplehyperplasia covered by cornified epithelium or proliferative squamousepithelium. Inflammation of larynx made the papillary expand, while themembrane of polyp could not be distinguished from normal membranes.(2) We found117lesions among the104patients. The histologicaldiagnoses of these lesions were as follows:16simple hyperplasia,15milddysplasia,7moderate dysplasia,12laryngeal polyp,3laryngitis,6severedysplasia,9carcinoma in situ,49invasive cancer.(3) The sensitivity of NBI to detect laryngeal carcinoma was91.4%(53/58).The sensitivity of normal mode to detect laryngeal carcinoma was74.1%(43/58), which shows statistically significant difference (χ2=6.04, p<0.05). Thenegative predictive value of NBI to detect laryngeal carcinoma was91.9%(57/62). The negative predictive value of normal mode to detect laryngealcarcinoma was78.6%(55/70), which shows statistically significant difference(χ2=4.53, p<0.05).Conclusion:NBI scope severs as a band-new endoscopic imaging diagnostic technique, which is easily operated, could apparently and clearly demonstrate the outline oftumors and the morphological changes of blood vessels in or under the morbidmembrane, and are useful for the primary judgement. NBI scope have highersensitivity and negative predictive value for laryngeal carcinoma than normallaryngoscope, which makes it an efficient tech to find out malignant tumorsquickly and classify different lumps.